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The following contraindications must be carefully considered by providers before initiating therapy

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DHA (docosahexaenoic acid) because it is an omega-3 fatty acid, has been reported to have anticonvulsant effects

For levothyroxine, oral semaglutide (Rybelsus) may increase thyroxine exposure by approximately 33%

Commonly reported side effects included: Nausea (the most frequently reported, particularly at higher doses) Vomiting Diarrhoea Decreased appetite Constipation Eructation (belching) At the 12 mg dose, gastrointestinal adverse events were reported in a higher proportion of participants compared with lower doses, though most did not lead to treatment discontinuation